Hispanics play an important economic role in the United States. In fact, Hispanics have a “demographic impact on the United States far beyond their relative importance within the total population because of their fertility rates” (Bergad & Klein, 2010, p.99). According to one report, if one will take away the presence of Hispanics in the U.S., America’s fertility rate will plummet like most European countries. In addition, the continuous immigration of immigrants from Mexico and other Latino countries adds more people into the overall population of the United States. In other words, there is a significant number of Hispanics that require adequate and appropriate healthcare.
In order to determine the barriers to culturally competent care for the said target population, it is imperative to point out that, “Latinos were far less likely to occupy higher-status and professional positions” compared to other residents of the United States” (Bergad & Klein, 2010, p.278). For example, only “16.7% of all Hispanics worked in higher-income professions” (Bergad & Klein, 2010, p.278). In addition, “Hispanics earned median personal incomes that were considerably lower than those found among the other racial groups” (Bergad & Klein, 2010, p.278). Furthermore, lower educational attainment levels are common among Hispanics. These issues have exacerbated the problems related to barriers in delivering culturally competent carrier.
There are at least three major barriers to the delivery of culturally competent care for members of the Hispanic population. These are listed as follows:
In addressing the problems created by the language barrier, it is not enough to simply learn how to speak Spanish. Health care workers, and health care professionals must understand the cultural belief system that gives meaning to those words. Health care professionals must understand the definition of terms when interpreted in their own context. For example, the term medicine is translated as acupuncture, herbal therapy, and spiritual remedy. In an ideal scenario, hospitals are staffed with nurses that are fluent in Spanish. However, it is impossible to maintain a significant number of Spanish speaking nurses under the employ a single health care facility.
The second major barrier that may prevent the delivery of competent care to Hispanics is the absence of a multicultural workplace. The establishment of a multicultural workplace goes beyond the hiring of Spanish-speaking nurses. It requires the establishment of a culture that encourages sincere appreciation of other people’s cultural values. It requires diversity awareness that fosters a workplace environment that embraces cultural difference among workers and patients. It requires the integration of workplace competence that includes cognitive and practical skills. Management must invest in educating health workers.
Opportunities must exist to develop cultural competence, and this includes continuing education, college courses, and advanced certificate programs (Jeffreys, 2010). It is easy to understand why multicultural workplace competence is absent in many U.S. healthcare facilities. In order to establish one, management must invest significant amounts of resources to create an atmosphere that celebrates the importance of culturally competent care.
The third major barrier to competent care towards members of the Hispanic population is racism. It is an extreme form of prejudice that “views persons born into a particular group as inferior in terms of intelligence, beauty or self-worth” (Stanhope, 2014, p.79). A negative consequence of racism is the denial of opportunities or service because of the person’s race (Stanhope, 2014). Nurses struggling to deal with the effects of racism may feel uncomfortable helping Hispanic patients.
An example of an ethical dilemma in the delivery of competent healthcare to Hispanics is the conflict of interest that arises from treating illegal immigrants. The ethical dilemma is difficult to resolve when it involves children of illegal immigrants. A nonpartisan policy research group based in Washington, D.C. released an interesting report asserting that: “Immigrants comprise over 12 percent of the U.S. population, and their children over 20 percent.
If current trends continue, children of immigrants will represent at least a quarter of all U.S. children by 2010” (The Urban Institute, 2006, p.1). Law abiding citizens are supposed to report illegal immigrants. If nurses have personal knowledge of the legal status of the child’s parents, is it the nurse’s duty to report them to authorities. This is an example of a serious ethical dilemma, because nurses were trained to provide competent care. In other words, they need to provide the best care possible. If these children are born in the U.S., they are American citizens. However, if their parents are deported, they have to go back where they came from. However, quality healthcare in their homeland is less than ideal.
Delivery of culturally competent care to members of the Hispanic population requires the eradication of several barriers. The obvious obstacle in health care delivery involving immigrants, and different people groups is language. The appropriate response is to hire nurses that are fluent in Spanish. However, in the medical profession, it takes more than Spanish-speaking health workers to ensure the delivery of competent care. It is important to establish a culture within the workplace that fosters sensitivity to cultural values. It is also important to invest in the acquisition of cultural competence through continuing education, college courses, and advanced certificate programs. These strategies eliminates racism in the workplace.
Bergad, L. & Klein, H. (2010). Hispanics in the United States. New York: Cambridge University Press.
Jeffreys, M. (2010). Teaching cultural competence in nursing and healthcare. New York: Springer.
Stanhope, M. (2014). Foundations of nursing in the community. CA: Elsevier Publishing.
The Urban Institute. (2006). Children of immigrants: Facts and figures. Web.
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